PHILADELPHIA ASSOCIATION OF INTERNS AND RESIDENTS AND COMMONWEALTH OF PENNSYLVANIA, PENNSYLVANIA LABOR RELATIONS BOARD, APPELLANTS,v.ALBERT EINSTEIN MEDICAL CENTER AND TEMPLE UNIVERSITY OF THE COMMONWEALTH SYSTEM OF HIGHER EDUCATION

This appeal arises from an order of the Commonwealth Court which reversed the Pennsylvania Labor Relations Board and the Court of Common Pleas of Philadelphia, in which the two tribunals held that interns, residents and clinical-fellows, members of the Philadelphia

[ 470 Pa. Page 565]

Association of Interns and Residents, one of the appellants herein, who perform services at the appellee-hospitals, are employees within the meaning of the Public Employe Relations Act, Act of July 23, 1970, P.L. 563. No. 195, art. I, § 101, 43 P.S. § 1101.101, et seq., hereinafter called "Act 195".

Initially, we must point out that, in our opinion, the appellant-employees of Albert Einstein Medical Center and Albert Einstein Medical Center itself no longer come within the purview of Act 195, but rather are covered under the "Labor Management Relations Act, 1947", Act of June 23, 1947, c. 120, § 1, 61 Stat. 136, 29 U.S.C.A., § 141, et seq. (Labor Management Act). In 1947, when the Labor Management Act was amended to redefine the terms used therein, § 152, Definitions, read as follows:

"(2) The term 'employer' includes any person acting as an agent of an employer, directly or indirectly, but shall not include the United States or any wholly owned Government corporation, or any Federal Reserve Bank, or any State or political subdivision thereof, or any corporation or association operating a hospital, if no part of the net earnings inures to the benefit of any private shareholder or individual, or any person subject to the Railway Labor Act, as amended. . . ." (Emphasis supplied.)

Under the terms of § 152 of the Labor Management Act, excluded from the term "employer" was any private nonprofit hospital and any hospital run by the state. Albert Einstein Medical Center is a nonprofit private hospital, and, therefore, excluded from the term "employer" in the Labor Management Act. If Albert Einstein Medical Center is excluded under the Labor Management Act, its employees would, therefore, be eligible to organize under state labor relations legislation as the interns, residents and clinical-fellows (hereinafter called appellants) attempted to do in January, 1970, under Act 195. However, during the time that the personnel of Albert Einstein

[ 470 Pa. Page 566]

Medical Center filed under Act 195 and the time this appeal arose, the Congress of the United States amended the Labor Management Act, § 152, Definitions, to read as follows:

"(1) The term 'person' includes one or more individuals, labor organizations, partnerships, associations, corporations, legal representatives, trustees, trustees in bankruptcy, or receivers.

"(2) The term 'employer' includes any person acting as an agent of an employer, directly or indirectly, but shall not include the United States or any wholly owned Government corporation, or any Federal Reserve Bank, or any State or political subdivision thereof, or any person subject to the Railway Labor Act, as amended from time to time, or any labor organization (other than when acting as an employer), or anyone acting in the capacity of officer or agent of such labor organization." (Emphasis supplied.)

Section 152 of the Labor Management Act, as amended in July of 1974, specially eliminated from its exclusion of defined employers, private nonprofit hospitals, such as appellee herein, Albert Einstein Medical Center; thus, on its face, § 152 of the Labor Management Act now includes as employers, hospitals such as appellee, Albert Einstein Medical Center. The legislative history surrounding the amendment of § 152 of the Labor Management Act reinforces the contention that private nonprofit hospitals are, since the 1974 amendment, covered by the Labor Relations Act. The legislative history clearly indicates § 152 was amended to bring within its purview employees of private, nonprofit hospitals. See 2 U.S. Code Cong. & Admin.News 1975, pp. 3946-3947.

Since the amendment to § 152 of the Labor Management Relations Act was intended to include employers such as appellee, Albert Einstein Medical Center, and since this amendment pre-empts the field of labor

[ 470 Pa. Page 567]

law regarding private nonprofit hospitals' employer-employee relationships, the issue of the status of the appellants who are employed at Albert Einstein Medical Center is now moot. Our decision as to the mootness of appellee Albert Einstein Medical Center in no way controls our decision on the issue of whether appellants who are at Temple Medical Center are employees within the meaning of Act 195, since this decision is purely a matter of state labor law.

We must now turn to the question of whether the interns, residents and clinical-fellows at Temple University Hospital are public employees within the meaning of Act 195. Since there is no dispute that Temple University is a public employer under § 301(1) of Act 195, 43 P.S. § 1101.301, we must look to see how Act 195, in § 301(2), 43 P.S. § 1101.301(2), defines public employee:

This very broad definition in § 301(2) sheds little light on what constitutes a public employee. Nor does the scant case law surrounding Act 195. In Sweet v. Pa. L. R. B., 457 Pa. 456, 322 A.2d 362 (1974), this court had its first opportunity to define who was an employer under Act 195, but did not define what is a public employee since in Sweet it was undisputed that the court personnel involved in the appeal were public employees.

In the instant case, the Pennsylvania Labor Relations Board and the Court of Common Pleas found the interns, residents and clinical-fellows of Temple University to be public employees within the meaning of Act 195 because of certain indicia of employee status. The two tribunals held that appellants were employees because (1) they spent eighty-five to ninety percent of their time in patient-care service, (2) they were paid wages that were subject to federal income tax, (3) only ten to fifteen percent of their time was spent in formal classroom instruction,

[ 470 Pa. Page 568]

and (4) that many other terms of their relationship with appellee Temple University carried indicia of employee status.

While accepting the findings of fact of the Pennsylvania Labor Relations Board, we, as did the Commonwealth Court, find that because of their unique position and status, appellants are not employees within the meaning of Act 195. The interns, residents and clinical-fellows at Temple University are at Temple not for the primary purpose of obtaining monetary remuneration, but rather to fulfill educational requirements. The interns are required by state law to serve a year of internship at an approved hospital in order to be admitted to the practice of medicine, which is, in essence, a fifth year of medical school. See "The Medical Practice Act of 1973," July 20, 1974, P.L. 551 No. 190, § 1, et seq., 63 P.S. § 421.1, et seq. and Title 49, Pennsylvania Code, § 17.11(f).

The residents who are at hospitals such as Temple are medical doctors admitted to practice, but who wish to specialize in a certain field of medicine and be certified by the medical association as specialists. The residency requirement is an integral step in the obtaining of board certification as a specialist and, again, this training can only be obtained at an approved hospital, such as Temple. See Title 49, Pennsylvania Code, § 17.41.

Lastly, the clinical-fellows at Temple are residents who have fulfilled their residency requirements, but stay at hospitals such as Temple in order to obtain more training in their specialty and ultimately go on to teach or do research in the medical field. Again, a portion of their time is spent either receiving instruction, teaching or doing research, all designed to further the educational level of appellants.

In our opinion, while appellants herein are clothed with the indicia of employee status, the true nature of their reason for being at Temple University negates

[ 470 Pa. Page 569]

their employee status. Appellants do not go to work at Temple in the true bargained-for exchange normally associated with the employer-employee relationship. Appellants are not primarily seeking monetary gain, but rather are attempting to fulfill educational requirements, either to initially practice medicine, or obtain certain specialties in the medical field. Moreover, appellants herein are not, because of certain medical board requirements, free to obtain this training from any hospital in the Commonwealth; appellants must work at a hospital approved as a teaching hospital, such as Temple. This again evidences that the general bargained-for exchange of the normal marketplace is absent in the instant case.

". . . They participate in these programs not for the purpose of earning a living; instead they are there to pursue the graduate medical education that is a requirement for the practice of medicine. An internship is a requirement for the examination for licensing. And residency and fellowship programs are necessary to qualify for certification in specialties and subspecialties. While the housestaff spends a great percentage of their time in direct patient care, this is simply the means by which the learning process is carried out. It is only through this direct involvement with patients that the graduate medical student is able to acquire the necessary diagnostic skills and experience to practice his profession. The number of hours worked or the quality of the care rendered to the patients does not result in any change in monetary compensation paid to the housestaff members. The stipend remains fixed and it seems clear that the payments are more in the

[ 470 Pa. Page 570]

nature of a living allowance than compensation for services rendered. Nor does it appear that those applying for such programs attached any great significance to the amount of the stipend. Rather their choice was based on the quality of the educational program and the opportunity for an extensive training experience. The programs themselves were designed not for the purpose of meeting the hospital's staffing requirements, but rather to allow the student to develop, in a hospital setting, the clinical judgment and the proficiency in clinical skills necessary to the practice of medicine in the area of his choice. . . ."

Lastly, we, as was the Commonwealth Court, are of the opinion that the spirit of Act 195 would not be served by allowing appellants to form a bargaining unit. Appellants do not comprise a group of persons who are attempting to establish a continuous relationship with appellee, but rather, after they have fulfilled their educational requirement in either one, two or three ...

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